The surgery process is typically composed of 5 steps. The first step is to make an incision in the gums where they will need to drill a hole for the dental implant. After the bone of the jaw is exposed they will start by drilling a pilot hole at high speeds to prevent burning or pressure necrosis of the bone. Next is drilling at a low speed to expand the pilot hole. They use progressively wider drills. Caution is taken not to cause damage to the bone cells by overheating. To keep the temperature low a saline or water spray is used. After the hole is made they will place the dental implant. Getting the implant in place requires precision as they need to not overload the surrounding bone. The last stage is to close up the incision made in the first step.
Dental implants can be inserted in one of two ways. It can be done after the extraction is healed or “immediate” or same-day insertion. The same-day insertion consists of putting the dental implants in on the same day that the tooth or teeth were removed. Same-Day dental implants offer the advantage of not having to go without any teeth. It can require multiple adjustments or other surgical procedures after the tissue heals.
One-stage surgery consists of getting the dental implant as well as the crown or dentures at one time. Two-stage surgery is where they place the dental implant into the jaw and then allow for a period of time to heal. Later the patient would need to go back for a second surgery to attach the crown or dentures. It used to be believed that doing two-stage surgery was better for the dental implant to heal and attach to the bone.
Recovery from a dental implant requires osseointegration to happen. Osseointegration is when the material of the dental implant forms an intimate bond with the bone around it. Research suggests that the initial stability of the implant to the bone is a more important determination of the success of the implant rather than a set recovery time. This means that the recovery time will typically depend on the density of the bone in which the implant is placed as well as the number of implants placed.
After the implants are placed they need to be cleaned as you would with natural teeth to remove plaque. A Teflon instrument is used to remove plaque. There is a more precarious blood supply to the gums surrounding the area, so you need to take caution when using dental floss. The crowns of single implants that are used to replace the missing tooth should be expected to need maintenance or repairs about every ten years. There are things that can affect this time frame such as the position of the mouth, force applied from other teeth and restoration material. Dental implants that are used for a complete denture, based on the type of attachment, need to be changed or refreshed every one to two years.